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Takaishi K, Otsuka R, Fujiwara SJ, Eguchi S, Kawahito S, Kitahata H. A Retrospective Case Series of Anesthetic Patients With Epiglottic Cysts. Anesth Prog 2021; 68:168-177. [PMID: 34606575 PMCID: PMC8500314 DOI: 10.2344/anpr-68-01-01] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Accepted: 09/04/2020] [Indexed: 11/11/2022] Open
Abstract
Previously undiagnosed or asymptomatic epiglottic cysts may be coincidentally detected during intubation. This retrospective case series identified undiagnosed epiglottic cysts that were discovered during intubation in 4 patients who underwent oral surgery under general anesthesia at our hospital during a 6-year period. Including 2 additional cases, 1 previously diagnosed and 1 detected during preoperative imaging, epiglottic cysts were observed in 6 of 1112 cases (0.54%) total. Among the undiagnosed epiglottic cyst cases, mild dyspnea on effort or snoring was reported in 2 patients, but all others were asymptomatic. Upon discovering previously undiagnosed epiglottic cysts during intubation, it is essential to proceed cautiously, remain alert for potential airway management difficulties, and avoid injuring or rupturing the cysts. In addition, any available preoperative imaging should be reviewed as information pertinent to the airway and any abnormalities may be useful. This report discusses the anesthetic care of 6 patients with epiglottic cysts that were previously known or initially discovered during intubation.
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Affiliation(s)
| | | | | | - Satoru Eguchi
- Assistant Professor, Department of Dental Anesthesiology,
Tokushima University Hospital, Tokushima, Japan
| | - Shinji Kawahito
- Designated Professor, Department of Community Medicine and
Human Resource, Tokushima University Graduate School of Biomedical Sciences,
Tokushima, Japan
| | - Hiroshi Kitahata
- Professor and Chairman, Department of Dental Anesthesiology,
Tokushima University Graduate School of Biomedical Sciences, Tokushima, Japan
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Wang GX, Zhang FZ, Zhao J, Wang H, Li HB, Wang XM, Zhang J, Ni X. Minimally invasive procedure for diagnosis and treatment of vallecular cysts in children: review of 156 cases. Eur Arch Otorhinolaryngol 2020; 277:3407-3414. [PMID: 32621247 DOI: 10.1007/s00405-020-06163-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 06/20/2020] [Indexed: 12/18/2022]
Abstract
PURPOSE Vallecular cyst is an uncommon but potentially life-threatening disease. The aim of this study was to review the presentation, evaluation, and treatment of vallecular cysts in children. METHODS Medical records of 156 patients treated for vallecular cysts between 2013 and 2016 were retrospectively reviewed. The patients were divided into four age groups for comparison of clinical data: A, < 1 month; B, 1-6 months; C, 7-12 months; and D, > 1 year. RESULTS The median age of all patients (98 males and 58 females) was 12.1 months (range 1 day-11 years), including 21, 86, 21, and 28 patients in group A, B, C, and D, respectively. A diagnosis of vallecular cysts was made for 135 patients using a combination of flexible laryngoscopy and ultrasound, and ten patients (all in group A) required pre-surgery ventilation support. The most common symptoms were wheezing (59.6%) and stridor (36.5%). Ten patients experienced difficulty with intubation. Endoscopic-assisted transoral coblation marsupialization was performed for all patients, combined with supraglottoplasty for 41 out of 68 patients with concurrent laryngomalacia. Patients in group D had a longer operation time and higher incidence of intraoperative bleeding, two of whom experienced post-operation recurrence, and symptoms resolved after a second operation in both cases. CONCLUSIONS Flexible laryngoscopy and ultrasound are recommended for a diagnosis in suspected cases of vallecular cysts. Coblation marsupialization has advantages of minor damage, low recurrence rate, and suitability for all age groups.
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Affiliation(s)
- Gui-Xiang Wang
- Department of Otolaryngology, Beijing Key Laboratory for Pediatric Diseases of Otolaryngology, Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health (NCCH), Beijing, 100045, China
| | - Feng-Zhen Zhang
- Department of Otolaryngology, Beijing Key Laboratory for Pediatric Diseases of Otolaryngology, Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health (NCCH), Beijing, 100045, China
| | - Jing Zhao
- Department of Otolaryngology, Beijing Key Laboratory for Pediatric Diseases of Otolaryngology, Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health (NCCH), Beijing, 100045, China
| | - Hua Wang
- Department of Otolaryngology, Beijing Key Laboratory for Pediatric Diseases of Otolaryngology, Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health (NCCH), Beijing, 100045, China
| | - Hong-Bin Li
- Department of Otolaryngology, Beijing Key Laboratory for Pediatric Diseases of Otolaryngology, Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health (NCCH), Beijing, 100045, China
| | - Xiao-Man Wang
- Department of Ultrasound, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health (NCCH), Beijing, 100045, China
| | - Jie Zhang
- Department of Otolaryngology, Beijing Key Laboratory for Pediatric Diseases of Otolaryngology, Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health (NCCH), Beijing, 100045, China.
| | - Xin Ni
- Department of Otolaryngology, Beijing Key Laboratory for Pediatric Diseases of Otolaryngology, Head and Neck Surgery, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health (NCCH), Beijing, 100045, China.
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Abstract
An infant who presents with stridor and apnea constitutes a challenge for emergency physicians in terms of diagnosis and management. Among the rarest of causes for these symptoms, congenital vallecular cysts can cause devastating outcomes if left undiagnosed. Reported here is a case of intermittent episodes of stridor and apnea in a 4-day-old neonate with a previously undiagnosed vallecular cyst. The process by which the infant was stabilized, correctly diagnosed, and successfully treated for a life-threatening airway obstruction is explained. After a discussion of vallecular cysts, methods for preparing for and executing proper airway management in an infant who presents with apnea and stridor are considered.
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Rigid endoscope-assisted orotracheal intubation for vallecular cyst surgery in neonates and young infants. Int J Pediatr Otorhinolaryngol 2018; 110:61-66. [PMID: 29859590 DOI: 10.1016/j.ijporl.2018.04.023] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Revised: 04/16/2018] [Accepted: 04/19/2018] [Indexed: 11/22/2022]
Abstract
OBJECTIVES To investigate the outcomes of rigid endoscope-assisted orotracheal intubation (REI) in neonates and young infants with difficult airway conditions as an alternative intubation technique when more specific airway instruments are not available in most developing countries, and to evaluate the safety and advantages of this method. METHODS Neonatal and young infantile patients undergoing vallecular cyst surgery with a Cormack-Lehane Grade 3 or 4 glottic view between June 2013 and June 2015 were studied. Fifteen patients were intubated using rigid endoscopic assistance. Fifteen other patients who were intubated using the conventional technique were selected from the previous consecutive cases and used as a matched control group. RESULTS REI was successfully performed in all 15 patients in one intubation attempt. The anesthetic preparation duration for the REI group was 6 min (interquartile range 5-7 min), which was shorter than the anesthetic preparation duration for patients intubated using the conventional technique (15 min [interquartile range 10-20 min], p < 0.001). The time required for intubation with a rigid endoscope was 66.5 s (interquartile range 58-74 s). No volume reduction of cysts or tracheotomies was needed in the REI group, and no cysts were ruptured nor did laryngeal mucosa damage occur with this technique. Among patients of conventional group, one required a tracheotomy, and four required cyst volume reduction by needle aspiration. No residual lesions or recurrence were observed during one year of postoperative follow-up in the REI group, and two recurrences were observed in the conventional group. CONCLUSION REI, which used common pieces of equipment in an otolaryngology operating room, may be a safe and feasible alternative for intubation in neonatal and young infantile patients with vallecular cysts or other difficult airway conditions.
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Lu D, Yu R, Yang H, Liu J. A bronchogenic cyst of the larynx: A case report. Exp Ther Med 2017; 14:5523-5526. [PMID: 29285086 DOI: 10.3892/etm.2017.5237] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Accepted: 07/20/2017] [Indexed: 02/05/2023] Open
Abstract
A 12-year-old female presented with a 2-month history of dyspnea and a progressively worsening hoarseness lasting >10 years. The subsequently identified mass was completely resected from the patient's supraglottic area using a laser and suspension laryngoscope. The mass was diagnosed as a bronchogenic cyst using histopathology. While the prognosis for these cysts is good, long-term follow-up remains necessary for such patients because there are several reports in the literature indicating the potential for malignancy to develop. The patient in the present study experienced no complications or recurrence of the bronchogenic cyst 2 years following surgery. To the best of our knowledge, only 2 cases of bronchogenic cysts arising from the larynx have been reported in China, and the present study introduces the first case of a bronchogenic cyst of the larynx in a Chinese patient reported in English.
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Affiliation(s)
- Dan Lu
- Department of Otorhinolaryngology, Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Rong Yu
- Department of Otorhinolaryngology, Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Hui Yang
- Department of Otorhinolaryngology, Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China
| | - Jun Liu
- Department of Otorhinolaryngology, Head and Neck Surgery, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China
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Wong CM, Ghazal EA, Dyleski RA, Applegate RL. Management of Near-Complete Airway Obstruction Caused by a Vallecular Cyst in an Infant Using a Tongue Tip Traction Suture. ACTA ACUST UNITED AC 2016; 6:31-3. [PMID: 26599736 DOI: 10.1213/xaa.0000000000000266] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Airway obstruction in infants can be because of a number of airway issues, one of which is a vallecular cyst. Although uncommonly seen, the management strategy for this difficult airway can be applied to many other difficult airway cases. We report the use of a preoperative oral fiberoptic assessment of the airway, use of a tongue stitch, and manipulation of a flexible nasal fiberoptic bronchoscope to secure the airway. Keeping the patient breathing spontaneously with low-dose ketamine also facilitated successful tracheal intubation.
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Affiliation(s)
- Christine M Wong
- From the Departments of *Anesthesiology and †Otolaryngology-Head and Neck Surgery, Loma Linda University School of Medicine, Loma Linda, California
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Lee SH, Lee DJ, Kim KM, Kim KN, Seo SW, Park YK, Cho SM, Choi YA, Lee JU, Lee DR. Epiglottic cyst incidentally discovered during screening endoscopy: a case report and review of literature. Korean J Fam Med 2014; 35:160-6. [PMID: 24921035 PMCID: PMC4040434 DOI: 10.4082/kjfm.2014.35.3.160] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Accepted: 04/14/2014] [Indexed: 11/25/2022] Open
Abstract
From the endoscopists' point of view, although the main focus of upper gastrointestinal endoscopic examination is the esophagus, stomach, and duodenum (usually bulb and 2nd portion including ampulla of Vater), the portions of the upper airway may also be observed during insertion and withdrawal of the endoscope, such as pharynx and larynx. Thus, a variety of pathologic lesions of the upper airway can be encountered during upper endoscopy. Among these lesions, an epiglottic cyst is relatively uncommon. The cyst has no malignant potential and mostly remains asymptomatic in adults. However, if large enough, epiglottic cysts can compromise the airway and can be potentially life-threatening when an emergency endotracheal intubation is needed. Thus, patients may benefit from early detection and treatment of these relatively asymptomatic lesions. In this report, we present a case of epiglottic cyst in an asymptomatic adult incidentally found by family physician during screening endoscopy, which was successfully removed without complication, using a laryngoscopic carbon dioxide laser.
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Affiliation(s)
- Seung-Hwa Lee
- Department of Family Practice and Community Health, Ajou University School of Medicine, Suwon, Korea
| | - Duck-Joo Lee
- Department of Family Practice and Community Health, Ajou University School of Medicine, Suwon, Korea
| | - Kwang-Min Kim
- Department of Family Practice and Community Health, Ajou University School of Medicine, Suwon, Korea
| | - Kyu-Nam Kim
- Department of Family Practice and Community Health, Ajou University School of Medicine, Suwon, Korea
| | - Sang-Wook Seo
- Department of Family Practice and Community Health, Ajou University School of Medicine, Suwon, Korea
| | - Young-Kyu Park
- Department of Family Medicine, Bundang Jaesang Hospital, Seongnam, Korea
| | - Sung-Min Cho
- Department of Family Medicine, Bundang Jaesang Hospital, Seongnam, Korea
| | - Young-Ah Choi
- Department of Family Medicine, Bundang Jaesang Hospital, Seongnam, Korea
| | - Jung-Un Lee
- Department of Family Medicine, Wonkwang University College of Medicine, Gunpo, Korea
| | - Dong-Ryul Lee
- Department of Family Medicine, Wonkwang University College of Medicine, Gunpo, Korea
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Clinical effect analysis of microscopic surgery for epiglottis cysts with coblation. Indian J Otolaryngol Head Neck Surg 2013; 66:267-71. [PMID: 25032112 DOI: 10.1007/s12070-013-0686-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2013] [Accepted: 10/24/2013] [Indexed: 10/26/2022] Open
Abstract
This study aims to explore the effects and advantages of coblation combined with microscopy to treat epiglottis cysts. Ninety patients with epiglottis cysts were randomly assigned to three groups: the first group: marsupialisation + electric coagulation group, n = 30; the second group: marsupialisation + coblation, n = 30; and the third group: marsupialisation + coblation + microsurgery, n = 30. To compare the cure rate, intraoperative bleeding volume, postoperative pain, operation time and postoperative complications were investigated among these three groups. The comparison among three procedures showed a significant difference for intraoperative bleeding volume, operation time and postoperative pain (P < 0.05), whereas no significant difference was observed for cure rate (P > 0.05). These three procedures are effective in treating epiglottis cysts. Microscopic surgery with coblation has the advantages of less bleeding, short procedure duration, less pain and few complications. Thus, microscopic surgery is worthy of clinical application.
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Tsai YT, Lee LA, Fang TJ, Li HY. Treatment of vallecular cysts in infants with and without coexisting laryngomalacia using endoscopic laser marsupialization: fifteen-year experience at a single-center. Int J Pediatr Otorhinolaryngol 2013; 77:424-8. [PMID: 23280279 DOI: 10.1016/j.ijporl.2012.12.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2012] [Revised: 11/30/2012] [Accepted: 12/04/2012] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To share our experience in treating a large cohort of infants with congenital vallecular cysts using endoscopic laser marsupialization. We describe the clinical characteristics of infants with pediatric vallecular cysts and compare these characteristics between infants with and without concurrent laryngomalacia and those who did or did not require preoperative airway support. METHODS Medical records of infants treated for vallecular cyst at Chang Gung Memorial Hospital between March 1994 and July 2008 were reviewed. Demographic and clinical characteristics and outcomes were recorded and compared. RESULTS Twenty-eight infants were included in our study: 11 (39.3%) males and 17 (60.7%) females. The incidence of vallecular cyst was 5.3 cases/100,000 live births. Median ages at symptom onset and diagnosis were 3.0 and 40.0 days, respectively. Mean symptom onset to diagnosis interval was 42.4 days. Eighteen (64.3%) infants had coexisting laryngomalacia and 11 (39.3%) required ventilatory support. The number of symptoms decreased in all patients after surgery (median no. symptoms before=4.5, after=0.5) and most symptoms were completely resolved within 3 months of surgery. Compared with infants who did not have laryngomalacia, infants with laryngomalacia: were younger at symptom onset (2 vs 10 days); had more symptoms before (5.0 vs 3.5) and after treatment (1.0 vs 0.0); had a longer length of hospital (14.6 vs 9.4 days) stay; and more commonly required airway intervention compared with infants without laryngomalacia (55.6% vs 10.0%: all P<0.05). Compared with infants who did not require ventilatory support, those that did: had a shorter interval between symptom onset and diagnosis (31.8 vs 49.3 days); were younger at the age of diagnosis (38.0 vs 49.0 days); had more symptoms before surgery (5.0 vs 4.0); had a higher prevalence of laryngomalacia (90.9% vs 47.1%); had a longer length of hospital (16.4 vs 10.4 days) stay (all P<0.05). CONCLUSIONS Our study included a large number of infants with vallecular cyst who were treated with endoscopic laser marsupialization. Of note, we found that a large proportion of infants had coexisting laryngomalacia, which appears to complicate the clinical presentation and management of vallecular cyst.
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Affiliation(s)
- Yao-Te Tsai
- Department of Otolaryngology, Chang Gung Memorial Hospital, Taoyuan, Taiwan, ROC
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Nouri-Merchaoui S, Yacoubi MT, Hmissa S, Kalamoun I, Mahdhaoui N, Seboui H. [Congenital laryngeal cyst: an uncommon cause of stridor in neonates]. Arch Pediatr 2012; 19:425-8. [PMID: 22381664 DOI: 10.1016/j.arcped.2012.01.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2011] [Revised: 09/06/2011] [Accepted: 01/20/2012] [Indexed: 11/29/2022]
Abstract
Laryngeal cyst is a rare but generally benign lesion in the larynx. It may cause stridor and life-threatening airway obstruction in early infancy. We report the case of a neonate who developed respiratory distress 24h after birth in relation with materno-fetal infection. Airway obstruction was then suspected because of stridor. A laryngeal mass was discovered at the time of intubation. The infant experienced a nosocomial infection and died on day 14 of life before any surgical treatment. Autopsy concluded in an epiglottic congenital laryngeal cyst.
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Rodrigues AJ, Cardoso SR, Cereda DCR, Gonçalves MEP. Cisto subglótico: uma causa rara de estridor laríngeo. J Bras Pneumol 2012; 38:138-9. [DOI: 10.1590/s1806-37132012000100019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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Zawadzka-Glos L, Frackiewicz M, Brzewski M, Biejat A, Chmielik M. Difficulties in diagnosis of laryngeal cysts in children. Int J Pediatr Otorhinolaryngol 2009; 73:1729-31. [PMID: 19800698 DOI: 10.1016/j.ijporl.2009.09.010] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/03/2009] [Revised: 08/31/2009] [Accepted: 09/06/2009] [Indexed: 11/29/2022]
Abstract
INTRODUCTION In larynx cysts may be localized in different regions: glottis, laryngeal pouch, epiglottis, aryepiglottic folds and subglottic area. It is difficult to estimate if the cyst is acquired or congenital. Symptoms of laryngeal cyst depend on the size and localization of the cyst and include: change in the tone of voice, dysphonia, hoarseness, dysphagia, laryngeal stridor and dyspnoea. Cysts of the larynx in infants are rare but the treatment is easy once the diagnosis is made. If mismanaged, the resulting respiratory obstruction can lead to serious complications. OBJECTIVE Analysis of cases of laryngeal cyst in children treated in the Department of Paediatric ENT Medical University of Warsaw. MATERIALS AND METHODS A retrospective analysis of 10 cases of laryngeal cyst in children treated in the Department of Paediatric ENT in Warsaw between 2000 and 2008 was made. RESULTS The authors analyzed indications to directoscopy, endoscopic presentation, problems with establishing the right diagnosis and management. CONCLUSIONS Using a direct laryngoscopy as a golden standard in children with stridor will reduce a number of false diagnosis.
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Affiliation(s)
- Lidia Zawadzka-Glos
- Department of Paediatric Otorhinolaryngology, Medical University of Warsaw, Poland.
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Nishimura B, Tabuchi K, Aoyagi Y, Tobita T, Wada T, Kohanawa R, Nagata C, Morishita Y, Hara A. Epiglottic cyst in an infant. Auris Nasus Larynx 2008; 35:282-4. [DOI: 10.1016/j.anl.2007.10.014] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2006] [Revised: 10/15/2007] [Accepted: 10/25/2007] [Indexed: 11/15/2022]
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Aubry K, Kapella M, Ketterer S, Massri K, Bessede JP. A case of laryngeal ductal cyst: antenatal diagnosis and peripartum management. Int J Pediatr Otorhinolaryngol 2007; 71:1639-42. [PMID: 17698210 DOI: 10.1016/j.ijporl.2007.06.020] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2007] [Revised: 06/27/2007] [Accepted: 06/30/2007] [Indexed: 12/29/2022]
Abstract
Laryngeal mucous cysts are rare congenital malformations of the upper aero-digestive tract. We report one case of a ductal cyst developed in the supraglottic area. The diagnosis of an antenatal malformation was suspected on the basis of a hydramnios development during pregnancy. Ultrasound scan showed a cervical anechogen mass. This led to a fetal MRI which showed the cyst extension. A management of delivery had to be prepared due to the risk of air obstruction at the birth. The treatment consisted of a marsupialization of the cyst under laryngo-endoscopic surgery. Six months follow-up showed no recurrence.
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Affiliation(s)
- Karine Aubry
- ENT Department, University Hospital Center, 2 Avenue Martin Luther-King, 87000 Limoges, France.
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Bamba H, Hirasugi K, Okano H, Nishio T, Uno T, Hisa Y. A newborn case of congenital laryngeal cyst complicated with pneumothorax and pneumomediastinum. Auris Nasus Larynx 2006; 33:207-10. [PMID: 16356675 DOI: 10.1016/j.anl.2005.09.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2005] [Accepted: 09/16/2005] [Indexed: 10/25/2022]
Abstract
Benign congenital laryngeal cysts are rare entities. They often cause chronic hoarseness and severe stridor. Case reports of congenital laryngeal cyst complicated with pneumothorax and pneumomediastinum are very rare. A 3,112 g full-term male newborn developed stridor which got worse during crying for 12 h after birth. Chest retractions were present with inspiration. Chest X-rays showed the presence of right pneumothorax and pneumomediastinum. Transnasal flexible laryngoscopic examination revealed a large cystic mass, which occupied almost the entire supraglottic airway. The operation was performed with the techniques of laryngomicrosurgery under general anesthesia. The cystic wall was punctured and serous liquid contents were aspirated. Excision of the entire cystic lesion was performed. The next day, extubation was performed without any troubles. The stridor had disappeared and the pneumothorax and pneumomediastinum were improved without further medical intervention. The histopathological examination revealed that the cystic wall consisted of normal squamous epithelial cells. It is reasonable to think that the high airway pressure due to congenital laryngeal cyst was responsible for pneumothorax and pneumomediastinum.
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Affiliation(s)
- Hitoshi Bamba
- Department of Otolaryngology-- Head and Neck Surgery, Kyoto Prefectural University of Medicine, Kawaramachi-Hirokoji, Kyoto 602-8566, Japan.
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Khashu M, Osiovich H, Kozak F, Pelligra G, Hirsh D, Smyth J. Congenital epiglottic cyst presenting with severe airway obstruction at birth. J Perinatol 2006; 26:71-2. [PMID: 16355107 DOI: 10.1038/sj.jp.7211414] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- M Khashu
- Department of Pediatrics, Division of Neonatology, University of British Columbia, Children's and Women's Health Centre of British Columbia, Vancouver, British Columbia, Canada
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Cheng KS, Ng JM, Li HY, Hartigan PM. Vallecular cyst and laryngomalacia in infants: report of six cases and airway management. Anesth Analg 2002; 95:1248-50, table of contents. [PMID: 12401604 DOI: 10.1097/00000539-200211000-00026] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
IMPLICATIONS This report describes difficulties encountered in the airway management of six infants with concurrent vallecular cyst and laryngomalacia. It is hoped that our experience will assist others in the management of such patients.
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Affiliation(s)
- Ka Shun Cheng
- Department of Anesthesiology, Chang Gung Memorial Hospital, Chang Gung University, Taipei, Taiwan.
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